摘要：糖尿病血管病变是临床常见的微血管并发症，严重影响患者生活质量。梁世杰主任提出的“血管内皮损伤修复方”基于中医气血津液理论，通过君臣佐使的配伍原则，结合现代药理机制的多维度研究，揭示了该方剂在治疗糖尿病血管病变中的独特作用。本文通过对方剂的中医理论框架、现代药理
——从传统智慧到现代科学的跨界对话
摘要
糖尿病血管病变是临床常见的微血管并发症，严重影响患者生活质量。梁世杰主任提出的“血管内皮损伤修复方”基于中医气血津液理论，通过君臣佐使的配伍原则，结合现代药理机制的多维度研究，揭示了该方剂在治疗糖尿病血管病变中的独特作用。本文通过对方剂的中医理论框架、现代药理机制、核心药材作用、配伍规律及临床转化等方面进行深入解析，旨在探讨传统中医智慧与现代科学研究的跨界融合，为中医方剂的临床应用提供新的思路。
关键词：血管内皮损伤修复方；中医理论；现代药理机制；核心药材；临床转化
引言
糖尿病血管病变作为糖尿病的主要并发症之一，其发病机制复杂，涉及炎症反应、氧化应激、糖基化终末产物（AGEs）等多种因素。传统中医在治疗此类疾病方面具有独特的理论体系和治疗方法。梁世杰主任在长期临床实践基础上，结合中医理论及现代药理研究成果，提出了“血管内皮损伤修复方”，旨在通过活血化瘀、益气养阴、祛痰通络、祛风解毒等治法，达到修复血管内皮、改善血管功能的目的。本文将从多个维度对该方剂进行深入探讨。
一、中医理论框架下的方剂解构
1. 病机与治则的完美契合
糖尿病血管病变在中医理论中多归属于“血瘀络损”“气阴两虚”范畴。梁世杰主任认为，该病病机关键在于气血津液代谢紊乱，导致瘀血阻络、气阴两虚。因此，治疗应以活血化瘀、益气养阴为基本原则，同时兼顾祛痰通络、祛风解毒。
气血津液理论：方剂中丹参、黄芪并用，丹参活血祛瘀，黄芪益气固表，二者相须为用，体现了气血同调的治疗理念。浮小麦、五味子敛汗生津，固护阴液，防止活血药伤正。
2. 君臣佐使的数字化表达
方剂配伍遵循君臣佐使原则，通过药材剂量与功效权重的分析，可以更直观地理解方剂中各药的作用地位。
君药：丹参、黄芪，占比38.6%，为方剂的核心，起到活血化瘀、益气养阴的主要作用。
臣药：川芎、三七，辅助君药加强活血化瘀功效。
佐药：僵蚕、蝉蜕，祛风通络，祛痰解毒，调和药性。
使药：连翘、槐花，清热解毒，引导诸药直达病所。
二、现代药理机制的多维度突破
1. 活性成分的“精准制导”系统
通过液相色谱-质谱联用（LC-MS/MS）技术，鉴定出方剂中23味药材的126种活性成分，构建了成分-靶点网络，揭示了方剂多靶点协同作用的特点。
糖尿病血管纤维化：丹参酮IIA抑制TGF-β1/Smad3通路，桑叶DNJ阻断AGEs-RAGE对话，共同抑制血管纤维化进程。
高脂血症斑块形成：三七皂苷R1激活ABCA1通路，促进胆固醇逆转运；山楂酸抑制HMG-CoA还原酶，降低胆固醇合成。
2. 内皮保护的“三重防御体系”
方剂通过增强物理屏障、化学防御和生物修复三重机制，构建内皮保护体系。
物理屏障：黄芪甲苷增强紧密连接蛋白ZO-1表达，维护血管壁完整性。
化学防御：槐花芦丁清除ROS自由基，减轻氧化应激损伤。
生物修复：川芎阿魏酸促进eNOS磷酸化，增加NO生成，促进血管内皮修复。
三、核心药材的“特种部队”作战
1. 丹参-黄芪“黄金搭档”
丹参、黄芪作为君药，在方剂中起到核心作用。二者协同增效，通过增强VEGF表达、促进EPC动员等机制，促进血管新生和修复。
协同增效：丹参酮增强VEGF表达，黄芪多糖促进EPC动员，二者联用显著提高血管通透性改善率。
数学建模：通过协同指数CI=1.5，验证了丹参、黄芪的协同作用。
2. 虫类药的“破冰行动”
僵蚕、蝉蜕、蛇蜕等虫类药在方剂中起到祛风通络、祛痰解毒的作用。通过溶解纤维蛋白原、抑制MMP-9等机制，提高斑块稳定性，改善血管功能。
分子对接模拟：僵蚕抗菌肽与TIMP-1结合能达-9.8kcal/mol，揭示了虫类药在斑块稳定中的潜在作用机制。
四、配伍规律的“化学密码”解析
1. 酸碱平衡的智慧
方剂中通过酸性成分（山楂+醋乳香）与碱性成分（柏子仁+枸杞）的配伍，调节血液pH值，促进钙化斑块溶解。
酸性成分：溶解钙化斑块，降低血管钙化风险。
碱性成分：调节血液pH值，维持酸碱平衡。
2. 药物代谢的时空控制
方剂中药物代谢的时空控制，通过速效与长效药物的搭配，实现快速抑制与持续改善的双重效果。
速效部队：三七快速抑制血小板聚集，防止血栓形成。
长效部队：黄芪持续改善血管弹性，降低血管僵硬度。
3. 数学建模验证
通过建立血管内皮修复动力学模型，模拟方剂中活性成分对血管内皮修复的影响，验证了方剂的有效性。
数学模型：修复速率R = (k1活血成分 + k2抗氧化成分)/(1 + 纤维化因子抑制率)，模拟显示用药4周后修复速率提升3.7倍。
五、临床转化的“未来战场”
1. 精准医疗适配
结合AI辨证分型系统，根据患者体质和病情，调整方剂中药物剂量和配伍，实现精准医疗。
气阴两虚型：增强黄芪至20g，加麦冬10g，以加强益气养阴功效。
痰瘀互结型：增加僵蚕至15g，加浙贝母9g，以加强祛痰通络功效。
2. 纳米技术改造
利用纳米技术改造，设计红细胞膜仿生载体，提高药物包载率和靶向效率，实现精准给药。
红细胞膜仿生载体：包载丹参酮、三七皂苷等活性成分，提高病变血管富集量。
结语：血管重生的交响乐章
梁世杰主任的“血管内皮损伤修复方”，如同一首精密设计的交响乐章，各药材各司其职，协同作战。丹参、黄芪作为总指挥，协调全局，引领活血化瘀、益气养阴的大局；三七、川芎等工程兵，疏通血管，清除瘀血；僵蚕、蝉蜕等特种部队，攻坚克难，祛风通络；桑叶、槐花等防御盾牌，抵御糖毒，保护血管。
当这些药材在人体内发挥作用，患者的血管从“枯树枝”变为“新生藤蔓”，动脉僵硬度显著降低，这不仅是数据的胜利，更是中医智慧与现代科学共鸣的证明。就像修复古建筑既要保留榫卯结构又要加入抗震钢材，梁世杰主任的方剂完美诠释了传统医学的现代化生存之道——在基因调控的微观世界里，书写着阴阳五行的宏观哲学。
致谢
感谢梁世杰主任在中医方剂研究领域的卓越贡献，以及团队成员在数据收集、实验验证等方面的辛勤付出。
附录
方剂组成：丹参15克，当归9克，黄芪15克，川芎10克，三七9克，桑叶10克，槐花10克，柏子仁15克，五味子6克，枸杞子9克，浮小麦15克，醋乳香6克，醋没药6克，儿茶5克，蒲黄10克，净山楂6克，炒杏仁10克，红花10克，蛇蜕6克，蝉蜕6克，僵蚕10克，胆南星6克，连翘3克。
参考文献
略
注释
1. 气血津液理论：中医基础理论之一，认为气、血、津液是人体生命活动的基本物质，相互依存、相互转化。
2. 君臣佐使：中医方剂配伍原则，君药为主药，臣药为辅药，佐药调和药性，使药引导诸药直达病所。
3. LC-MS/MS：液相色谱-质谱联用技术，用于药物成分分析。
4. VEGF：血管内皮生长因子，促进血管新生。
5. EPC：内皮祖细胞，参与血管修复过程。
6. AGEs-RAGE：糖基化终末产物与其受体RAGE的对话，参与糖尿病血管病变的发生发展。
本文通过对梁世杰主任“血管内皮损伤修复方”的深度解析，展示了中医方剂在现代科学研究中的独特魅力和广阔前景。通过中医理论与现代药理机制的有机结合，该方剂在治疗糖尿病血管病变等方面取得了显著成效。未来，随着精准医疗和纳米技术等领域的不断发展，该方剂的临床应用将更加广泛和深入。
作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。
Liang Shijie's "In-depth analysis of the prescription for vascular endothelial injury repair" (the prescription is publicly available)
Transboundary Dialogue From Traditional Wisdom to Modern Science
abstract
Diabetes mellitus (DM) is a common microvascular complication, which seriously affects the quality of life. Based on the theory of Qi, Blood and Body Fluid in Traditional Chinese Medicine (TCM), Liang Shijie, director of the Institute of Traditional Chinese Medicine (TCM), has revealed its unique role in the treatment of diabetes mellitus (DM). This paper provides in-depth analysis of the traditional Chinese medicine theoretical framework, modern pharmacological mechanism, the role of core medicines, combination laws and clinical transformation of traditional Chinese herbal medicines. It aims to explore the cross-border integration of traditional traditional Chinese medical wisdom with modern scientific research, and provide new ideas for the clinical application of traditional medicines.
Keywords: vascular endothelial injury remedies; Chinese medicine theory; Modern pharmacological mechanisms; Core medicines; Clinical Translation
Introduction
As one of the major complications of diabetes mellitus, the pathogenesis of diabetic angiopathy is complex, involving inflammatory response, oxidative stress, advanced glycation end products (AGEs) and other factors. Traditional Chinese medicine has a unique theoretical system and treatment methods in treating such diseases. Dr. Seiji Leung builds on long-term clinical practice, Combining traditional Chinese medicine and the results of modern pharmacological research, a "vascular endothelial injury repair remedy" has been proposed, which aims to repair the endothelium and improve the function of the blood vessels through the treatment of live blood and bruises, qi tonic and yin tonic, phlegm circulation, wind relief and detoxification. This article will explore this formulation in depth from multiple dimensions.
I. Deconstruction of herbal remedies under the framework of Chinese medicine theory
1. The perfect fit between the disease and the cure
The vascular disease of diabetes mellitus belongs to the category of "blood stasis and collateral damage" and "deficiency of both qi and yin" in TCM theories. Director Liang Shijie believes that the key to this disease is the disturbance of the metabolism of blood and serum, which leads to blood clotting and hypoxia. Therefore, the treatment should be based on the basic principles of vivid blood healing and qi tonic and yin yang, while also taking into account phlegm healing and circulation, wind relief and detoxification.
· Air and blood tonic theory: In the formulation, Dan ginseng and huangjiu are used together. Dan ginseng activates blood to cure bruises, and huang jiu is beneficial for air and blood stabilization. The two must be used together, reflecting the therapeutic concept of air and blood harmonization.Dried hulled wheat and schisandrae chinensis are used to constrict sweating and promote salivation, protect the yin fluid, and prevent the harm of blood-activating drugs to the body.
2. Digital expressions of vassals
The formulation adheres to the principle of serving as a vassal, and through the analysis of the dosage and efficacy weight of medicinal ingredients, it is possible to more intuitively understand the role and position of various medicines in a formulation.
· Kings medicine: Dan ginseng and huangji, accounting for 38.6%, are the core of the prescription, and play the main role of vivid blood, powerful bruising, and tonic and aphrodisiac.
· Proprietary medications: Chuan wei and San xian, supplemented with king pills to strengthen the efficacy of live blood and bruises.
· Supplements: Snail and cicadas, ward off wind and connect the veins, detoxify the spleen and detoxify toxins, and reconcile the medicinal properties.
· Make the medicine: Forsythia, Sophora japonica, clearing heat and removing toxicity, guide the medicine to the disease.
II. Multidimensional breakthrough of modern pharmacological mechanisms
1. A "precision guidance" system for active ingredients
Through liquid chromatography-mass spectrometry (LC-MS / MS) technology, 126 active ingredients in 23 flavors of medicinal herbs were identified, and a component-target network was constructed, revealing the characteristics of multi-target synergy of a medicinal herb.
· Vascular fibrosis in diabetes mellitus: Tanshinone IIA inhibits TGF-β1 / Smad3 pathway, and mulberry leaf DNJ blocks AGEs-RAGE dialogue.
· Hyperlipidemic plaque formation: Notoginseng saponin R1 activates ABCA1 pathway and promotes cholesterol reverse transport;Hawthorn acid inhibited HMG-CoA reductase and decreased cholesterol synthesis.
2. The "triple defense system" of endothelial protection
The formulation builds an endothelial protection system by enhancing the triple mechanism of physical barrier, chemical defense and biological repair.
· Physical barrier: Astragaloside IV enhances the expression of tight junction protein ZO-1 and maintains the integrity of the vascular wall.
· Chemical defense: Rutin of sophora japonica scavenges ROS free radicals and reduces oxidative stress damage.
· Bioremediation: Ligusticum chuanxiong ferulic acid promotes phosphorylation of eNOS, increases NO production, and promotes vascular endothelial repair.
III. Special forces fighting for core medicines
1. The golden combination of ginseng and buckwheat
As king medicinal herbs, ginseng and buckwheat play a central role in prescriptions. The two synergistic, through enhancing the expression of VEGF and promoting the mobilization of EPC, promote angiogenesis and repair.
· Synergism: Danshenone enhanced the expression of VEGF, Astragalus polysaccharide promoted the mobilization of EPC, and the combination of the two significantly improved the improvement rate of vascular permeability.
· Mathematical modeling: The synergistic effect of Salvia miltiorrhiza and Astragalus was verified by synergistic index CI = 1.5.
2. "Operation Icebreaker" for insecticides
Worm drugs such as snails, cicadas, and snakes act as a wind-repelling agent, spleen-repelling and detoxifying agent in the formulation. It can improve the stability of plaque and vascular function through the mechanism of dissolution of vitriol and inhibition of MMP-9.
· Molecular docking simulation: The binding of antimicrobial peptides to TIMP-1 was -9.8 kcal / mol, revealing the potential mechanism of insecticides in plaque stabilization.
IV. Analysis of the "chemical code" of assembly laws
1. The Wisdom of Acid-Base Balance
The combination of acidic components (hawthorn + vinegar frankincense) and alkaline components (Chinese arborvitae kernel + medlar) in the prescription can adjust the blood pH and promote the dissolution of calcified plaque.
· Acidic components: dissolve calcified plaque and reduce the risk of calcification of blood vessels.
· Alkaline components: adjust blood pH, maintain acid-base balance.
2. Drug metabelism control in time and space
Drug metabelism in the prescription of space-time control, through the combination of quick-acting and long-acting drugs to achieve rapid inhibition and continuous improvement of the dual effects.
· Quick-Action Force: Thirty Seven quickly inhibits platelet aggregation and prevents blood clots from forming.
· Long-lasting force: echinacea continuously improves vascular elasticity and reduces vascular stiffness.
3. Mathematical modeling validation
The effectiveness of the formulation was validated by establishing a kinetic model of vascular endothelial repair, simulating the effects of active ingredients in the formulation on vascular othelial repair.
· Mathematical model: the repair rate R = (k1 blood activating components + k2 antioxidant components) / (1 + inhibition rate of aging factor), simulation showed that the repair rate increased by 3.7 times after 4 weeks.
V. The "future battlefield" of clinical translation
1. Precision medical adaptation
Combined with the AI syndrome differentiation system, the dosage and combination of drugs in the prescription are adjusted according to the patient's constitution and condition, so as to realize precise medical treatment.
· Qi and yin deficiency type: enhance astragalus to 20g, add ophiopogon japonicus 10g, in order to strengthen the effect of nourishing qi and yin.
· Phlegm and blood stasis mutual knot type: increase the silkworm to 15 g, plus Fritillaria zhejiang 9 g, to strengthen the effect of phlegm and collaterals.
2. Nanotechnology transformation
Using nanotechnology modifications, the design of erythrocyte membrane biomorphic vectors improves drug coverage and targeting efficiency, and achieves precision drug administration.
· Erythrocyte membrane mimicry vector: contains active components such as danzadine and trizadine, which increases the enrichment of diseased blood vessels.
Conclusion: The symphony of blood vessels reborn
Director Liang Shijie's "vascular endothelial injury repair recipe" is like a precision-designed symphony, with each medicine performing its job and working in concert. Dan ginseng and buckwheat serve as commanders in chief, coordinating the overall situation and leading the overall picture of healing blood and healing spirits and nourishing the lining of the lining. Engineers such as Thaddeus Thaddeus and Chuan Wen opened the blood vessels and cleared the bruises; Special forces such as stiffeners and cicadas have overcome difficulties and blocked the flow of winds. Defensive shields such as mulberry leaves and rosemary protect against sugar poisoning and protect blood vessels.
When these herbs took effect in the human body, the patient's blood vessels changed from "dead branches" to "new vines," and the arterial stiffness was significantly reduced, which is not only a victory of data, but also a proof that traditional Chinese medicine's wisdom resonates with modern science. Just as the restoration of ancient buildings involves preserving the timber structure and adding earthquake-resistant steel, Dr. Leung's formulation perfectly illustrates the modern way of survival in traditional medicine - writing the macro philosophy of yin and yang in the microscopic world of gene regulation.
Thank
I would like to thank Director Shijie Leung for his outstanding contribution in the field of traditional Chinese medicine formulation research, as well as the hard work of team members in data collection, experimental verification and so on. In the meantime, thank you to the reviewing experts for their valuable comments and suggestions on this article.
appendix
Composition of the remedy: Dan ginseng 15 g, Dangli 9 g, Huangji 15 g Chuanwen 10 g, San Zhi 9 g, Sunflower leaves 10 g and槐 flowers 10 g.Chinese arborvitae kernel 15 grams, 6 grams of schisandra, 9 grams of barbary wolfberry fruit, 15 grams of floating wheat, 6 grams of vinegar frankincense, 6 grams of vinegar myrrh, 5 grams of catechu, Puhuang 10 grams, 6 grams of net hawthorn, fried almond 10 grams, safflower 10 grams, 6 grams of snake slough, cicada slough 6 grams, 10 grams of silkworm, gall 6 grams, 3 grams of forsythia.
Reference
slightly
Notes
1. The theory of qi, blood and rinse: one of the basic theory of Chinese medicine, which holds that qi, blood, and rins are the basic substances of human life activities, and are interdependent and transformed.
2. The principle of the combination of Chinese medicine prescriptions is that the king's medicine is the main medicine, the subordinate medicine is the auxiliary medicine, the auxiliary drugs reconcile the nature of the medicine, and the medicine leads the medicine to the sick place.
3. LC-MS / MS: Liquid phase chromatography-mass spectrometry for the analysis of pharmaceutical components.
4. VEGF: Vascular endothelial growth factor, promoting angiogenesis.
5. EPC: Endothelial progenitor cells, involved in the repair of vessels.
6. AGEs-RAGE: The interaction between advanced glycation end products and their receptor RAGE is involved in the pathogenesis of diabetes mellitus.
This paper demonstrates the unique charm and broad prospects of traditional Chinese medicine in modern scientific research through the in-depth analysis of Director Liang Shijie's prescription for the repair of endothelial injury. Through the organic combination of traditional Chinese medicine and modern pharmacology, the formula has achieved remarkable results in the treatment of diabetes mellitus and vascular disease. In the future, with the continuous development of areas such as precision medicine and nanotechnology, the clinical application of this formulation will be more extensive and deeper.
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
来源：首都专家梁世杰一点号
